0536 The Diagnostic Yield of a Structured Comorbidity Workup in a Real-Life OSA Outpatient Population

Abstract Introduction Obstructive sleep apnoea (OSA) is a highly prevalent sleep-related breathing disorder with systemic complications, which exerts important effects on health burden and also influence the management strategies. However, evidence-based recommendations on systematic comorbidity screening approaches remain sparse. Methods This single-centre prospective observational study included patients diagnosed with OSA at the sleep center and evaluated the diagnostic yield of a structured comorbidity workup, including laboratory testing, electrocardiogram, echocardiography, abdominal ultrasound, ambulatory blood pressure monitoring, spirometry, and questionnaires. Results A total of 1904 OSA patients (age 46±12 years, 82% male) were included. Prior to the diagnostic workup, patients presented with a medical history of a median of two [IQR 1-2] comorbidities and a mean of two [IQR 1-2] new comorbidities were diagnosed with the protocolied workup. Overall, the most prevalent comorbidities were hypertension (30%), dyslipidaemia (55%), non-alcoholic fatty liver disease(29%), metabolic syndrome (31%), type 2 diabetes mellitus (32%), hyperuricemia (29%), heart failure with preserved ejection fraction (13%), significant coronary artery disease (15%), arrhythmia(16%), obesity hypoventilation syndrome (19%), chronic obstructive pulmonary disease (8%) and anxiety or depression (17%), gastro-oesophageal Reflux Disease (17%),asthma (12%), and thyroid dysfunction (6%). In multi variable regression analysis, older age, male sex and mean pulse oxygen saturation were independently associated with a greater number of total comorbidities. Of all newly diagnosed comorbidities, 40% prompted initiation or adjustment of pharmacological therapy, 54% led to specialist referral, and 85%resulted in lifestyle or behavioral interventions. Conclusion A structured, comprehensive comorbidity workup in real-life OSA outpatients identifies a high prevalence of previously unrecognized, clinically actionable conditions, most commonly cardiometabolic complications. Integrating such screening into routine OSA care may provide an opportunity to improve risk stratification, treatment strategy optimization, and adverse outcomes prevention. Support (if any) This work was supported by National Natural Science Foundation of China (82470091)